BRIEF REPORT
Hwayeon Myeong, MEd; Elisabeth R. Silver, PhD; Jazmin Argueta-Rivera, MA; Dillon Stewart, MA; Mikki Hebl, PhD; Eden B. King, PhD
Corresponding Author: Hwayeon Myeong, MEd; Department of Psychological Sciences, Rice University.
Email: hm60@rice.edu
DOI: 10.3122/jabfm.2025.250377R1
Keywords: Access to Primary Care, Health Disparities, Insurance, Patient Appointments, Patient Education, Primary Health Care, Social Determinants of Health, Texas, Waiting Lists
Dates: Submitted: 09-25-2025; Revised: 01-22-2026; Accepted: 02-16-2026
Status: In Press.
OBJECTIVE: Emerging evidence suggests that inequities in healthcare access can occur during appointment scheduling. This study examined whether patient race, gender, and self-advocacy styles shape appointment access in primary care, and whether requesting an earlier appointment affects scheduling outcomes.
METHODS: In a telephone-based audit study, 24 trained research assistants used pseudonymous names signaling race and gender to pose as new patients calling primary care clinics in major metropolitan areas of Texas. Callers followed a standardized script to request an initial appointment and, after receiving an offer, were instructed to ask whether an earlier appointment was available using different self-advocacy styles. Of 5,760 call attempts, 798 calls met the inclusion criteria and were analyzed. Each call was coded for the appointment offers, wait times, and whether requests for an earlier appointment were accommodated.
RESULTS: Scheduling outcomes did not differ significantly by race, gender, or advocacy styles. However, when requests for earlier appointments were accommodated, callers received substantially shorter wait times, regardless of demographic characteristics.
CONCLUSIONS: Although we find no evidence of differential treatment based on perceived race, gender, or self-advocacy styles at the scheduling stage, requesting an earlier appointment was associated with meaningful reductions in wait time. These findings suggest that encouraging asking at the scheduling stage may help reduce disparities in timely access to primary care.